Provider Demographics
NPI:1558483180
Name:GENTLE TOUCH FAMILY DENTISTRY
Entity Type:Organization
Organization Name:GENTLE TOUCH FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:CHESKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-375-8860
Mailing Address - Street 1:1450 GINGER WOODS CT
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5401
Mailing Address - Country:US
Mailing Address - Phone:312-375-8860
Mailing Address - Fax:
Practice Address - Street 1:1450 GINGER WOODS CT
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5401
Practice Address - Country:US
Practice Address - Phone:312-375-8860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026416122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty